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Thread: Little 18 month old...should I worry?

  1. #1
    Join Date
    Nov 2006

    Default Little 18 month old...should I worry?

    Hi Ladies,
    So Eden had her 18 month check up yesterday, and the pedi is worried b/c she's only 20 pounds (3rd percentile...she's 32 inches, or 65% for height). Basically, the dr told us to put butter on EVERYTHING (we already do use butter on her veggies) and add pediasure to her diet instead of cow's milk. She encouraged she eat more red meat (she already lives on meatballs) and giver her things like pancakes and waffles slathered in butter for breakfast. She also kind of hinted i needed to wean her totally (we have 2-4 sessions a day now) so she'll be more interested in "real" food. I know BM is higher calorie than most other foods, so i'm just going her ignore her innuendo about BFing totally. The pedi also wants us to see a nutritionist and a gastroenterologist. Now, I don't mind seeing a nutritionist, but i really feel like i'm well informed and i'm not just guessing at what my baby should be eating, I'm willing to do it though. However, i do not want to put Eden through unnecessary medical tests at the gastroenterologist when I KNOW she's healthy. I really really don't believe she has some sort of digestive problem or intolerance. The kid is totally regular and happy and active and comfortable. My gut is just telling me she's petite (both me and her dad were very small for our ages as kids). She's meeting all her milestones early and if her body has enough nutrients to grow taller than average, i'm led to think that's just the way she's built. I feel like a bad mom wanting to go against dr's orders, but i just really don't think there's anything wrong. I don't even think we should bother with the nutritionist, but there maybe something we could learn...A typical daily menu would go something like this
    Breakfast of 1/2 peanutbutter sandwich on whole wheat toast, or 1 egg on toast with fruit (1 bananna or about 1/2 an apple) and some whole milk


    Snack- 2-4 oz cheese and whole wheat crackers or O's, full fat yogurt with fresh fruit (about 1/3 to 1/2 c yogurt)

    Lunch- 2-3 meat balls (or meat loaf...sometimes chicken or lentils if she'll eat it) 2/3 C steamed veggies in butter (broccoli, grean beans, carrots, asparagus, squash, anything really...) and whole milk

    snack- usually our "bad" snack...animal/gram crackers and cheese/ yogurt.


    Dinner- usually roughly the same as lunch

    Nurse before bed.

    She also drinks whole milk or water all day (usually about 8-10 oz milk and lots of H20)

    I do give more of a variety, but this is just to give you an idea...it doesn't seem lacking to me. What do you ladies think?

    Sorry for the novel, and TIA!!

  2. #2
    Join Date
    Mar 2006

    Default Re: Little 18 month old...should I worry?

    Been there. My ped said my kiddo wasn't eating enough because she was nursing so much and encouraged me to cut back on the breastmilk. It does have calories, but I DO believe it also keeps kids thin at that age. I did cut back a LITTLE... it was time to start limiting her a bit for reasons other than getting her to eat more anyway. But for the most part I didn't change too much. She was also short for her age. What MY ped did was have her keep coming back every.. was it couple weeks or month?.. just to get another weight check. My ped ended up not concerned because while she was small and light, she WAS gaining. So she didn't order any tests. When that doc left and we got a new ped, I asked her about it and she looked at me and said, well YOU'RE not exactly big. She's perfectly healthy. There's no reason to worry. This doc is VERY young.. I'm thinking that the older docs are so used to formula fed patterns that our trim kids worry them. Note that there is a rise in childhood obesity. I wouldn't really WANT my kid to follow the same curve as the AAP chart which is based on white American formula fed kids from the 50's. Check the W.H.O. charts and plot your child on that. That compares breastfed children with good health care and nutrition from all around the world.

    I did push food a little harder after all the slow weight gain issues. Well, now her bmi is quite high - higher than I'd like, to be honest. She's a very short 3 year old with a chubby belly. Beautiful.. but certainly not in need of butter!!! Fat is still very good for someone your child's age... but don't push it so hard that she grows up to enjoy dipping corn chips in butter at the restaurant (yes my child did this... ew.)

    3rd percentile is still on the charts. She doesn't sound malnourished. If she has completely stopped gaining for sometime, it may be worth checking to make sure everything is working right (not celiacs or something) but like you said.. she's healthy. Is her hemoglobin good? Is her poop normal? No tummy aches? No rashes? If so, I'd probably hold back on huge tests.

    The awesome thing about bf is that you know she's getting plenty of good stuff that she CAN digest regardless. So if there is a problem, all the more reason to bf. If not... well then there isn't.

  3. #3
    Join Date
    May 2006

    Default Re: Little 18 month old...should I worry?

    Well....first off, I think your 18 mo. old is eating a TON! That's more than my 20 mo. old son ever eats, LOL.

    He's a smaller one too, but I do think he was about 22lbs at 18 mos. and 32.5 inches tall.

    If you are concerned about her weight, then you could try adding more variety into her diet and probably adding more carbs and cheese(cheese is pertty high calorie). Pizza can be healthy if you make it that way and has alot of calories, as does lasagna (we make ours with strictly mozzerella instead of ricotta), full fat cottage cheese, homemade burritos (tortillas actually are pretty high in calories). If she doesn't like the mexican spices, try just browned ground beef with cheese and maybe diced tomatoes ...maybe even diced cooked carrots in there? Pasta is also another good one. Whole grain pasta is very healthy, but even the regular stuff can be ok. Homemade Mac N Cheese...you can add various veggies to that too and even browned ground beef for a meal that kids genereally really like.

    You can also do pancakes, french toast, or waffles with fruit, or egg omelets with veggies and cheese. Even adding texas toast or buttered garlic bread will probably add more calories.

    If you'd prefer to use something other than real butter, we actually use Earth Balance Natural Buttery Spread. It's vegan(even though we aren't) and is non-hydrogenated, non-genetically modified, non dairy, natural oil blend. It takes remarkably like margarine/butter, and you can cook with it too. Basically its made from soybean, palm fruit, canola, and olive oil in a blend. It's actually 100 calories per Tablespoon, so that's pretty high I think. It's actually supposed to help improve the good to bad cholesterol ratio too, so it might be a healthier option than real butter.

  4. #4
    Join Date
    Sep 2007

    Default Re: Little 18 month old...should I worry?

    I have a little one, too - she's in at best the 5 percentile on height and weight (25% on head - but that's a different story). She's 2.5 years old and hasn't been BF in 2 years (we stopped at 6 months). Anyway, my point is - even non-BF kiddos can be tiny (I'm short, DH isn't). So, I don't think it's the BM personally - I think you may just have a small child - and there's nothing wrong with that for sure!

  5. #5
    Join Date
    Nov 2007

    Default Re: Little 18 month old...should I worry?

    We had major weight issues with my LO, yes they did suggest cutting back on bf, I never did. We heard all the same things about butter etc. She was healthy and active as well. It turns out she DOES have celiac disease, but I have to say, other than not gaining as she should we saw NO signs of it. Right before she had her intestine biopsy the doctor said 'I don't think she has it' then after looking at the biopsy he was convinced she did. I'm just saying, please don't completely eliminate the possibility!
    Anyhoo, at a time when she just wasn't gaining and was getting used to a gluten free diet, yup, we gave her ice cream dessert at every meal. It sounds horrible! But it did help get her up in weight a bit. And it wasn't a ton and we eliminated it as she started eating more food.

    Now she's doing great, she's made a huge jump in weight (and is NOT on an ice cream diet anymore) AND she is still breastfeeding (2 3/4).

    Sounds like your lo is eating a wide variety and actually quite a lot of food (which is again another reason to double check on celiac!) and you really arent breastfeeding that often.

    I'm sorry to push the check out other possibilities thing, but personally I felt it was much better to know, I've stopped stressing about eating all the time, she's changed from a active and happy baby into a super active and happy toddler. If we lived elsewhere (I live in Sweden) I don't know if they would have tested her and who knows how it would have affected her in the long run. BTW my little one also had good height growth the entire time.

    Your post sounds EXACTLY how I did a little over a year ago. Just because your child isn't showing extreme symptoms (like stomach discomfort and so on) doesn't mean that there isn't a potential problem. Lactose intolerance can have the same sort of effect.

    Good luck!

  6. #6
    Join Date
    Jun 2006
    Not around here as much :(

    Default Re: Little 18 month old...should I worry?

    Someone has to be at the tail end of those charts... I'd worry more about how consistent her growth is as opposed to where she plots out on that chart. JMO I cant believe the doc suggested butter on 'everything' - guess she's trying to ensure another hypertensive patient in the futrue, eh?
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  7. #7
    Join Date
    Jul 2006

    Default Re: Little 18 month old...should I worry?

    I am surprised that your ped is so alarmed. Has she been growing consistently? My LO weighed only 18.5 lbs at 17 months. She probable won't even be at 20 lbs when she goes in for her 18 month check up. Our per has never been alarmed with her small size because she is healthy, active, and has always grown consistently. I personally wouldn't stress and I probably wouldn't start putting butter on everything! Mayby try getting a second opinion before moving on to a nutritionist and gastroenterologist.
    Mom to a beautiful little girl-born June 27th, 2006

  8. #8
    Join Date
    Dec 2007

    Default Re: Little 18 month old...should I worry?

    Her eating looks fine to me. My daughter was 20 pounds at 18 months, and ate well and still nursed 4-5 times a day...and she was healthy but tiny. She's still tiny at age 5, but has had a growth spurt in height.

    As long as she's growing and eating ok, I would tend to not worry so much about it. I'm also surprised at your ped's alarm about this...like the pps I think it sounds like she is healthy and just fine. She's probably an active toddler who just happens to be on the small end of the spectrum!

  9. #9
    Join Date
    Nov 2006

    Default Re: Little 18 month old...should I worry?

    Thanks for the replies everyone. I'm at work and i don't have all the stats, but i do remember she weighed 17.5 pounds at her 12 month check up, and she weighs 20 now, so that's about a 6.6oz gain per month. I think i read somewhere that 7-11oz gain per month is normal ...so she's a little behind..but not a lot. that's also assuming i'm remembering what i read correctly. I wish i had her baby book!! I can't remember how much she weighed at her last two appts, The doc did mention she was falling on the chart, but still gaining, and since she started walking and was so active it wasn't something to be worried about. Ugh. I remember the days when just agonizing over my weight was exhausting...i had no idea. Oh motherhood....

  10. #10
    Join Date
    Mar 2007

    Default Re: Little 18 month old...should I worry?

    My DD eats a lot at 12 months and she is only 18 pounds (6th percentile I believe). My pro-bf doctor's only comment when we asked if there was a weight issue was that someone has to be at the bottom of the scale. She also encouraged me to let DD have as much bm as she wanted (I asked how much she should be drinking at 12 months and ped said as much as she wants!).

    Anyway, are you comfortable getting a second opinion? I don't want to tell you to disregard your ped's opinion because I am not a doctor and do not know your situation. But, maybe another ped might make you more comfortable with your lo's weight so you are comfortable forgoing the gastro tests? Good luck!
    Mom to Lainey (11-8-06)

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